الفهرس 
Evaluation of micro-osteoperforation on the rate of maxillary en-masse retraction: A randomized controlled trial
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Abstract
This was a Randomized controlled study that evaluated the effect of micro-osteoperforations during en-masse anterior retraction using miniscrews as anchorage in patients requiring extraction of upper first premolars.
A sample of 22 female patients were successfully recruited and the procedure was explained in detail with its expected benefits and they were asked to sign a written informed consent.
The study commenced with bonding a full orthodontic appliance with sequential wire upgrading, until reaching 0.016 x 0.022 NiTi wires. As for bi-alveolar dental protrusions cases, the lower premolars were extracted and lower anterior segment retraction and intrusion commenced, preceding the upper arch with 3 months to avoid contact between the upper and lower anterior teeth.
Miniscrews were inserted between the upper second premolars and first molars. This was followed with the insertion of an accentuated upper 0.017 x 0.025 st.st arch wire with crimpable hooks between the upper lateral incisors and canines. Forces were adjusted using a force gauge to apply 150 gm for each side.
A small round bur was used to make three vertical MOPs interdentally on the labial side and two vertical MOPs interdentally on the palatal side starting distal to the canines, with avoidance to the region between the central incisors to avoid injury to anatomical structures present in this region. This was repeated every 28 days for 5 months. Every patient was asked to report the pain score on the day of the procedure, after 24 hours, after 7 days and after 28 days.
Pre-retraction CBCT images and impressions were taken at the first visit of retraction (T0), upper impressions were taken at every visit and post-retraction CBCT images were taken at the last visit (T5).
The outcomes evaluated were the amount and rate of anterior en-masse anterior retraction, tipping, vertical displacement and root resorption. As for the posterior teeth, tipping, bodily displacement and rotations were evaluated.
As for the skeletal outcomes, vertical and anteroposterior changes of the maxilla were evaluated represented in changes in A and Prosthion points in relation to Palatal and Frontal planes respectively.
from the results of the clinical and statistical analyses the following conclusions could be drawn:
1. MOP was not capable of accelerating tooth movement.
2. All anterior teeth showed significant retraction and intrusion.
3. Upper lateral incisors root resorption was less in the intervention group.
4. The use of miniscrews in this study augmented the anchorage, since no significant anchorage loss was seen in either groups, on the contrary distalization of the 1st molars was present.
5. Pain after MOP was regarded as moderate to severe and gradually faded with the 28th day.